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The overuse of antidepressants

I know so many people taking antidepressants. And they talk about it quite openly, with me and with each other.

“What are you taking? Zoloft? Oh, I tried that but didn’t like it. Celexa works better for me.”

I’m sure none of these people went to his or her (mostly her) doctor and got a prescription for no reason whatsoever. But it’s pretty hard to deny that antidepressant use in this country has skyrocketed over the last two decades, which begs the question: Is everyone really that depressed?

Many individuals who are prescribed and use antidepressant medications may not have met criteria for mental disorders. Our data indicate that antidepressants are commonly used in the absence of clear evidence-based indications.

Among antidepressant users, 69% never met criteria for major depressive disorder (MDD); and 38% never met criteria for MDD, obsessive-compulsive disorder, panic disorder, social phobia, or generalized anxiety disorder in their lifetime.

Those most likely to be prescribed antidepressants were Caucasian women with some other type of health problem, such as back pain, overactive bladder or high blood pressure.

Women’s emotionality is a sign of health, not disease; it is a source of power. But we are under constant pressure to restrain our emotional lives. We have been taught to apologize for our tears, to suppress our anger and to fear being called hysterical. The pharmaceutical industry plays on that fear, targeting women in a barrage of advertising on daytime talk shows and in magazines.

More Americans are on psychiatric medications than ever before, and in my experience they are staying on them far longer than was ever intended. As a psychiatrist practicing for 20 years, I must tell you, this is insane. We need to stop labeling our sadness and anxiety as uncomfortable symptoms, and to appreciate them as a healthy, adaptive part of our biology.

Of course there are legitimate reasons to take antidepressants and anti-anxiety meds. But my advice with any medication is to take the smallest effective dose for the least amount of time. As Dr. Holland points out, and my own circle of friends proves, women are staying on these drugs indefinitely. No doubt they are afraid of what will happen to them emotionally if they quit.

And there is also a reason these drugs are aggressively marketed to middle-aged Caucasian women: they usually have decent health insurance and can afford the drugs.

This study confirms for me several things wrong with our health care system. One, drug companies are allowed to advertise their products directly to the general public. Two, doctors and other prescribers are too quick to write prescriptions, especially if a patient demands a specific drug after seeing it advertised. And three, patients aren’t taking charge of their own health and asking more questions about non-medication treatment options.

I get it, time is short and everyone is looking for the quick fix, the path of least resistance. But I can’t help but feel sad that the majority of people taking antidepressants right now might not be getting the help they really need.

Sláinte,

Frugal Nurse

Dr. Holland also wrote this great book!

Moody Bitches: The Truth About the Drugs You’re Taking, the Sleep You’re Missing, the Sex You’re Not Having, and What’s Really Making You Crazy